Back and neck pain are usually the symptoms associated with underlying causes such as a herniated disc, muscle spasms, sciatica, and so on.

When it comes to managing your health, knowledge is power. In this post, you will be introduced to different neck pain and associated problems.

You will also learn about what are the main causes and risk factors of neck pain, signs and symptoms to watch out for, and treatment and prevention options available for neck pain.

You will also learn about the five best exercises for neck pain and for each of the associated problems.

Can neck pain be a sign of something serious?

The neck consists of several vertebrae which extend from the skull through the length of your upper torso. Cervical discs are present between the bones and act as shock absorbers.

Your neck supports the head and promotes motion through the muscles, ligaments, and bones in it.

Neck pain or stiffness can be caused due to any injury and any abnormalities or inflammation in these components. Experiencing neck pain or stiffness occasionally is common.

This is usually due to maintaining a poor posture, whiplash, or other injuries. It's not usually a serious condition and resolves itself within a couple of days.

If the neck pain persists for more than a week, is severe, or is accompanied by any other symptoms, you need to seek medical attention immediately.

When acute neck pain persists for 4- 12 weeks or more, it is known as chronic neck pain.

What are the Signs and Symptoms of Neck Pain

In this section, let's look at some of the most common signs and symptoms of chronic neck pain.

• Any difficulty in moving or soreness, especially when you try to move your head sideways, a sharp localized pain that typically occurs in the lower neck. This pain is similar to a stinging or stabbing sensation.

• Any radiating pain along the nerve from the neck into your arm and shoulder, and a general feeling of soreness around the neck area.

• If your neck feels achy, tender, or you experience a burning or a searing sensation in your shoulder and arm, it's a sign of chronic neck pain.

• Any neurological defect that affects your strength, reflexes, or sensations can occur in the arm due to the compression of nerve roots. If there is any weakness or numbness in your arms or fingers, you might have trouble lifting or gripping objects.

• Another common symptom you need to watch out for is inexplicable headaches. At times, an irritation or inflammation in the neck affects the nerves and muscles connected to the head. Neck pain may also cause headaches and migraine

• If the neck pain progresses, you might have trouble sleeping, performing simple daily activities such as getting dressed, driving, or even going to work.

• Neck pain might be quite mild at the beginning of the day and gradually worsen at the end of the workday.

• It can also start after an injury or an uncomfortable sleeping position. They can also be a delayed onset of neck pain associated with accidents and injuries.

If it is minor neck pain, it usually goes away within 2-3 days. On the other hand, if it is chronic neck pain, you need to seek medical help immediately.

If the neck pain presents itself with severe headaches, stiffness, fever chills, loss of bladder or bowel control, problems with coordination and balance, a feeling of weakness converting, and numbness in the limbs, or radiating pain in the limbs, do not ignore it.

At times, neck pain can be caused by underlying medical problems such as meningitis, spinal cord compression, infection, or in extreme cases, cancer.

What causes neck pain without injury? Causes of Neck Pain

Following are some of the main common causes for chronic neck including:

• Neck injuries,
• Muscle tension and strain,
• Underlying medical condition.
• Muscle tension and strain are usually caused due to poor posture, improper posture while sleeping, working at a desk for too long without any breaks or changing the position, and if your neck jerks during an exercise.
• When it comes to injuries, the neck is perhaps the most vulnerable body part. This is especially true in the case of car accidents, falls, or even injuries caused during sports. In such injuries, the ligaments and muscles in the neck are forced to move outside their usual range. The spinal cord can also be damaged if the cervical vertebrae are fractured. Any injury caused due to the sudden jerk of the head is known as whiplash.
• When the thin tissue surrounding the brain and spinal cord is inflamed, it results in a condition known as meningitis. Those with meningitis frequently experience headaches, fever, and stiffness in the neck. This is a medical emergency and should not be ignored.
•  Neck pain can at times be a symptom of a heart attack. If you are worried, other symptoms of a heart attack you need to look for are nausea, jabbing pain in the arm, shortness of breath, vomiting, and excessive sweating.
• Apart from all the causes mentioned above, other causes can result in chronic neck pain. These are rheumatoid arthritis, fibromyalgia, osteoporosis, spondylosis, spinal stenosis, and a herniated cervical disc. Since rheumatoid arthritis results in painful swelling of the joint and bone spurs, it can trigger chronic neck pain. Similarly, osteoporosis increases susceptibility to small fractures due to the weakening of the bones.
• Fibromyalgia is a painful condition characterized by severe muscle pain throughout the body, including the neck and shoulder regions.
• Spondylosis is the condition that causes the degeneration of cervical discs. It essentially reduces the space between the vertebrae and increases the stress on the joints.
• Spinal stenosis is a condition characterized by the narrowing of the spinal column, increasing the pressure placed on the spinal cord. This condition can also be triggered by long-term inflammation associated with arthritis. At times, congenital abnormalities, abscesses, spinal cancer, tumors, and infection can also cause neck pain.
• Cancer or spinal tumor

What are the Risk Factors associated

One of the most common causes of chronic neck pain is aging. As you age, certain changes tend to take place in your neck joints due to bone spurs, dehydration, or even disc herniation.

All these age-related factors increase the stress on the neck joints and cause chronic neck pain.

Other than age-related factors, those with genetic factors or a family history of certain medical conditions that can trigger chronic neck pain, such as cervical spondylosis, are at a greater risk.

Likewise, any work-related activity that increases or places extra strain on the neck, such as heavy lifting or sitting in uncomfortable positions for a prolonged period and repeating the same neck movements, can cause repetitive stress resulting in chronic neck pain.

Leading a sedentary lifestyle and being overweight or obese can also increase the strain on the neck muscles while supporting your body weight.

This, coupled with smoking and being physically inactive, increases the risk of chronic neck pain.

Stress and anxiety related neck pain

Treatment Options How can I relieve my neck pain

Living with chronic neck pain can be debilitating. It prevents you from doing activities you love and harms the overall quality of life.

Several treatment options are available to reduce, manage, and alleviate neck pain ranging from self-care to physical therapy and medical intervention.

• Simple self-care practices include taking short breaks while performing strenuous activities, gentle muscle stretches, and applying ice or heat to the affected area.
• If your chronic neck pain is caused due to poor posture or sitting for prolonged periods in an awkward position, please change it.
• Start taking a couple of breaks during work hours to reduce the stress on the neck. Performing gentle neck stretches can help ease the tension in the muscles and reduce the pain.
• Leading a physically active lifestyle, quitting smoking, and maintaining an ideal neck posture are other changes you can make to reduce chronic neck pain.

Physical therapy

Physical therapy can be used to increase the flexibility and strength of neck muscles. The structure and length of the physical therapy program will vary depending on the diagnosis and severity of the situation.

Working with a trained physical therapist and following the prescribed exercises will help.

Takeaway 1: always use a physical therapist who is also a trained massage therapist and knows how to releases muscles and facias.

For most neck and back conditions, muscules-related deep tissue and facia release massage is very helpful.

If a therapist also knows how to point and target trigger points in your neck and shoulders, that will be a plus point to have relief from a nerve pain

Takeaway 2: if your neck or back pain is not related to bones or your spine means simple soft tissue injury (muscular or ligaments injury); avoid a chiropractor from cracking your neck as it may cause more pain.

This is a personal experience, and I have been told by hundreds of my patients that they have been to the chiro and caused more pain. Now the question arises that who will help then.

The answer is a physical therapist who is trained in manipulating soft tissue and knows how to release muscular fascia and nerves.

Another option is doing self-massage take some oil or lotion stand in front of a mirror, and deep massage on the neck and upper shoulders.

There is a massage or tennis ball option, but I will not recommend it, as some people apply too much pressure and cause more soft tissue injury, but if you apply control pressure, then it is also a good  option to relieve pain

The other option is If you are lucky to have a caring partner or parent, you can ask them to provide you deep massage with a thumb or fingers with some lotion or oil.

In return, you can cook for them if you are a good cook or if you are not good at cooking, then don’t promise you may feel better from neck pain, but they may have to suffer from bad taste or upset stomach.

Takeaway 3: The answer to pain relief and injury healing is not always stretching or exercises as if you do not treat soft tissues such as muscle, ligaments, and tendons, the pay may disappear with painkillers or simple few stretches but will come again and become chronic pain.

So please ask your therapist to provide you hands-on treatment, including manual manipulation, massage therapy, and once the pain disappears and your body part becomes pain-free, start your strengthening exercises and regular stretches to prevent the injury from happening again.  

Takeaway 4: Avoid self-diagnosing yourself by reading irrelevant articles online or buying and spending money, or I will say, wasting money on such things that are not helpful.

It will not only prolong recovery if you start then treatment but may also cause you more problems if you do certain methods and exercises that can damage the muscles, tendon, or disc further more.

It may also cause stress and anxiety by false and overthinking about your injury. So please always take medical advice from a licensed Medical Health Professional.

Short-term treatment options

There are several short-term treatment options for relieving chronic neck pain available, including over-the-counter pain relief medications.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for tackling chronic pain.

You might also be prescribed a combination of opioid and muscle relaxants and NSAIDs by your medical practitioner as a short-term maintenance plan.

Make sure that you strictly follow the doctor's directions, don't take any unprescribed medications, and seek help if the pain doesn't go away even after using these drugs.

Takeaway 5: During my everyday clinical experience with thousands of patients and treating several injuries and health conditions, including sciatica, rotator cuff injury, frozen shoulder, Nerve entrapment, and bulging discs, the best drug that is more helpful and effective is Naproxen 500mg twice a day.

It will help to reduce any inflammation in the area and promote tissue healing. (please ask your GP if you are allergic or have any other health conditions) may need to take along with Naproxen some Omeprozol for stomach acidity)

Alternative Therapies

Massage therapy, acupuncture, and manual manipulation by an osteopath or massage therapist can help improve your range of motion and reduce neck pain.

Deep tissue massage will help to release muscular tension and spasm and will help to improve acute pain.

Takeaway 6: At times, simply distracting your mind from the pain and concentrating on something else through meditation, or taking a hot shower or bath, or having a strong coffee is also helpful to reduce pain.

 (make sure you do not take coffee or tea after 3 pm in the afternoon if you have difficulties in sleeping.  

Takeaway 7: Pain becomes more tolerable when you can regulate your breathing. Sometimes deep breathing very helpful if you have sudden neck or back pain i.e. if your neck or back is lock in one position or suffering from severe muscular spasm.   

Deep breathing in from the mouth and exhaling through the nose helps to ease the pain.

Takeaway 8: Heat/cold therapy will help promote circulation and help you relieve pain.

Apply first cold, and then heat will help if you have any pain due to muscular spasm. If you have any fresh injury, then only apply cold in a tea towel or tissues

TENS, EMS and Massagers

TENS, EMS, and vibrators or massagers also helpful if you are suffering from chronic pain.

TENS works as a nerve stimulator under the skin and helps release natural pain killers in the local area to improve pain.

EMS and massagers also produce circulation to the painful area and relieve pain.

Please make sure you get a good quality product and read all your contraindications and instructions carefully.

Ultrasound Therapy:

Using therapeutic ultrasound at low frequency will help promote healing.  If there is any inflammation, it develops in the nerve roots at the neck/cervical region.

In simple words, without using long medical words to confuse, therapeutic ultrasound helps promote healing and bring circulation to the injured area.

It also produces internal tissue warmth and is helpful in the treatment of muscular spasms.

Always ask your physical therapist for the contraindications of using ultrasound.

Cortisone/steroid injection

Cervical spine injections as part of a therapeutic injection procedure can provide relief from chronic neck pain.

The most common procedures included in this treatment option are cervical epidural steroid injection, trigger point injection, and radiofrequency ablation.

In a cervical epidural steroid injection, a cortisone steroid solution is injected into the cervical epidural region using x-ray guidance in the form of contrast-enhanced fluoroscopy.

The cervical epidural space refers to the outer layer of the spinal canal. The idea is to tackle inflammation in the nearby nerve roots or tissues.

If the chronic neck pain is due to disc herniation or spinal degeneration, cervical epidural steroid injection helps.

Please always discuss with your consultant and consider the precautions accordingly by consulting with your doctor.

Radiofrequency ablation

Radiofrequency ablation or RFA is an efficient therapy option if the pain source is from an identifiable facet joint.

Fluoroscopy is used to guide and identify the right place where a special needle is placed near the sensory nerve adjacent to a facet joint.

This creates a barrier to reducing pain signals stemming from the region to the brain. It offers long-lasting relief when compared to the previous method.

But will need to look for all precautions and side effects as they may vary from person to person.

Trigger Point Injection

The third option of injection therapy is a trigger point injection. Even though no solution is injected into the area with dry needling, a thin needle such as an acupuncture needle is used.

Or a consultant can provide cortisone injections in multiple trigger points. A mild local anesthetic can also be used to calm a trigger point or the bundle of irritated nerves during this therapy.

These therapy options work by reducing inflammation and blocking pain stemming from a localized region.

Instead of addressing the underlying cause of chronic neck pain, this option offers relief but maybe temporary relief.

For long-term relief, you need to consider alternative therapeutic options and make favorable lifestyle changes such as exercising regularly and quitting smoking.

Prevention:

The simplest way to prevent back and neck pain or reduce it from worsening is by adjusting your neck position while sleeping.

We all use pillows, but choosing the right one is essential for the cervical spine's neutral alignment.

It essentially means the neck's natural curvature. A relatively flat pillow can reduce your neck pain when you lie down on your back.

On the other hand, an orthopedic pillow with a more profound depression can increase the support available to your neck.

Try sleeping on an adjustable bed or even lying on your side to find a position that is most comfortable for you.

If you shift from one position to another while sleeping, make sure you have a couple of pillows around to support all your different sleeping positions.

As a rule of thumb, try to sleep on your back or side as much as possible. The pillow should not be more than 4-6 inches thick.

A simple tip to remember is that the best position to sleep in is one that allows your entire spine to rest comfortably.

Whether you are sleeping at a slight incline or placing a pillow under each arm, try to provide your body the support it needs.

The idea is to ensure the natural curvature of the spine is maintained at the neck and lower back region to promote internal healing and reduce any discomfort or pain causing by neck twists or tension.

At work, sit in a comfortable, supportive chair and make sure the desktop or laptop is at eye level.

It means your gaze needs to directly go toward the top one-third of the computer screen.

Avoid placing your laptop in the lap or using a position that constantly shifts your head to a downward angle.

The neck muscles and spine need to support the weight of your head. When you keep looking down, this increases strain and can stiffen the muscles, so ensure your workspace is optimized to reduce any neck pain or discomfort.

Mobile phones have become an extension of our bodies these days. The modern culture of staying plugged in at all times means we are constantly checking our phones, texting, and responding to notifications.

If you keep looking down at the device as you text, it increases the stress on ligaments, joints, and discs in your neck.

These changes trigger premature degeneration of neck muscles. As with the computer or laptop, the smartphone screen should also be at eye level to prevent neck pain.

If you usually spend a lot of time on your phone, avoid cradling the phone in the crook of your neck or tilting your head to one side for prolonged periods.

Occasionally, these positions don't harm your neck health. If this becomes the norm, it once again increases the strain on the neck muscles.

To reduce and prevent neck pain, strengthening your neck muscles is a good idea. Simple strengthening and stretching exercises can reduce your neck pain, ease the tension, and strengthen the muscles.

Follow the simple exercise suggestions given in the next section to attain this goal.

If you are used to carrying a heavy briefcase or handbag, it's time to make a few changes. Carrying such heavy loads daily increases and creates an uneven strain on the neck and shoulders muscles.

Instead of briefcases or handbags, opt for backpacks as much as you possibly can because they offer even weight distribution on upper shoulders and neck.

Poor posture places strain on your neck muscles and increases the risk of neck pain and injury. Perhaps the most common example of poor posture is one where your head and shoulders lean forward.

Don't let your neck slant forward so that your head lies in front of the shoulders. An additional 10 pounds of weight is added as a force to your upper back and neck for every inch your head moves forward.

So, if your head moves 4 inches forward, it means you have increased the strain on your upper back and neck by 40 pounds.

The ideal head posture is to tuck your chin inward. This prevents your body from slumping forward and reduces the risk of unnecessary strain on the spine.

Exercises for neck pain

From poor posture to repeated forward body movements, different factors can trigger neck pain. Neck pain can cause headaches, reduce your mobility, and is extremely uncomfortable to live with.

Use yoga and regular neck stretches to get rid of neck pain and strengthen your muscles in the upper back, neck and shoulders. In this section, let's look at a few simple yoga poses designed to reduce neck pain.

Learn more about Neck Pain Exercises

Warrior II Pose

This is an incredibly simple yoga pose that helps strengthen, engage, and release any tension present in your chest and shoulders while supporting the neck.

To get started, stand on the yoga mat. Shift your right foot back so that your toes face the right at an angle.

Move your left foot forward. The inside of your right foot needs to align with the left one. Your arms need to be parallel to the floor while your palms face downward.

Move your left knee without overextending it further than your ankle. Elongate your spine while pressing your feet into the yoga mat.

Gaze ahead and past your left fingertips. Hold this pose for 30 seconds and repeat it on the other side.

Standing Forward Bend

To get started with this position, stand on the yoga mat comfortably. Stand so that your feet are aligned with your hips.

Now, it's time to elongate your body and bend forward while slightly bending your knees. You can use a yoga block or any other prop while performing this pose.

The aim is to bend forward so that your hands are close to your legs. If you can reach the floor, that's good, and if not, you can always use a yoga block during the initial stage.

Let your neck and head fully relax while you are bending forward and move your chin toward the chest.

Slowly shake your head from side to side or in a circular motion. This releases any tension in your shoulders and neck.

Hold onto this position for a minute. To end this pose, slowly raise your arms and head while you stand straight. Avoid jerking or making any abrupt movements while releasing this pose.

Thread the Needle Pose

Relieve the tension in your back, shoulder, and neck while strengthening them using this position.

Get down on your hands and knees, so your knees are under your hips and chest under the shoulders.

Lift your left hand and move it over to the right side along the floor while your palm faces upward.

Press your right hand into the floor or the yoga mat to support your body weight and rest your body on your left shoulder while looking over your right side.

Stay in this pose for 30 seconds. Take a few deep breaths and slowly release this pose. Repeat it on the other side.

Cow Face Pose

This pose helps stretch the muscles in your chest and shoulders while relaxing them. To get started, find a calm spot for yourself and sit comfortably.

Raise your right elbow and bend your arm so that your hand rests on your back. Use your left hand to pull your right elbow over to the left.

Alternatively, use your left hand to reach up and hold your right hand.

Hold this pose for 30 seconds before repeating it on the other side.

Extended Puppy Pose

This pose helps relieve any stress in your back and stretches shoulders. It also alleviates neck pain in the process.

First, place yourself down on all fours so that your breasts are directly below your shoulders and your knees under your hips.

Move your hands forward and lift your heels until you are up on your toes. Push your buttocks toward your heels and stop halfway down.

Start engaging the muscles in your arms and lift your elbows. Move your head forward until your forehead rests on the floor or the yoga mat.

Let the muscles in your neck fully relax. As you press into your palms, lower your back slightly, stretch your arms, and push your hips toward your heels.

Hold this pose for a minute.

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